Insurance Forms


 
 
 

Marshall & Sterling Insurance is pleased to provide important forms from many of the major health carriers with which we work. You can download enrollment and claim forms for the carriers listed below. This "one-stop" service provides access to these forms in one convenient location. We encourage you to visit this section as we expand the available forms.

 

Please note that Adobe Acrobat is required to view documents.



Medical Enrollment Form 2-50
Medical Enrollment Form 51+
NY Small Group Employer Application
Proof of Eligibility Form
Student Questionnaire



Medical Enrollment Form
Student Verification Form

 

Medical Enrollment Form
Medical Claim Form

Dental Enrollment Form
Dental Claim Form


Medical Enrollment Form
Medical Claim Form
Student Coverage Questionnaire

Medical Enrollment Form - PPO
Medical Enrollment Form - HMO
Medical Claim Form

Dental Enrollment Form
Dental Claim Form
Voluntary PPO DMO Dental Enrollment Form

 

Medical Enrollment Form-Charter EPO
Medical Enrollment Form-Outlook EPO
Medical Enrollment Form-Outlook POS
Change-Cancellation Form

 


Medical Enrollment Form
Medical Claim Form

 

Medical Enrollment Form
Medical Claim Form

 

Medical Enrollment Form
Medical Claim Form (Excel format)
Student Waiver Form

Dental Enrollment Form
Dental Claim Form

Dental/Vision Enrollment Form
Dental Claim Form

 

Medical Enrollment Form-Metro
Medical Enrollment Form-Standard
Medical Claim Form
Student Verification Parent Affidavit Form
Additon Termination Change Form



Medical Enrollment Form
HSA Account Enrollment Form
HSA Check Card Enrollment Form

 


Dental Enrollment Form
Dental Claim Form

 



Dental Enrollment Form
Dental Claim Form

 



Medical Enrollment Form
Medical Claim Form